CQC report explained · a residential care home
What the CQC found at Woodham Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2023
Woodham Grange rated Requires Improvement; inspectors found risks in record-keeping, medicines and dehydration monitoring, although staff knew people well and there were enough staff.
Inspectors made an unannounced visit on 25 April 2023. They spoke with people, relatives and staff, observed care, and checked care records, medicines, risk assessments, recruitment records and management checks.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. Records about accidents, incidents, risks, behaviour, fluid intake and medicines were not always complete or properly checked. One person was at risk of dehydration because their fluid intake was low and there was no clear target for staff to follow.
Inspectors found enough staff, suitable recruitment checks and staff who understood people and their communication needs. The home was working on an improvement plan and had a new registered manager since the previous inspection. The previous overall rating was Good, published in February 2020.
Enough staff
Inspectors found enough staff, including staff to support people with one-to-one activities. Recruitment checks were also in place.
“There were enough staff on duty, including for one-to-one support for people to take part in the things they wanted to do, when they wanted to do them.” from the report
Staff knew people
Staff understood people's needs, including their communication needs, and knew how to recognise and respond to abuse.
“Staff had received training in safeguarding and understood how to recognise signs of abuse and what actions to take to safeguard people from avoidable harm.” from the report
Health support
The home sought advice from health and social care professionals when needed.
“Records highlighted advice and guidance was sought from health and social care professionals when required.” from the report
Positive culture
Relatives and staff described a positive atmosphere and caring attitudes. Staff said they felt supported by management.
“Many of the people and staff we spoke with told us they saw an improvement in the service and the culture.” from the report
Risk records
seriousAccidents and incidents were not always recorded or reviewed on the correct system. Risk assessments did not always explain how risks were being reduced.
“We found incidents that had not been reviewed by the registered manager as they had not been completed on the correct system.” from the report
Dehydration risk
seriousOne person had very low recorded fluid intake on several dates. Staff did not know the fluid target they should be aiming for.
“Fluid recording showed on 5 different dates in April this person had consumed less than 350ml of fluid.” from the report
Medicine records
needs fixingSome medicine information was not stored where it could be found, and handwritten administration records were not double signed. CQC recommended an urgent review.
“Handwritten medicine administration records were not double signed as per best practice.” from the report
Limited choice at meals
needs fixingThe menu showed only one option, and inspectors did not see staff ask whether a person wanted something different before supporting them with their meal.
“We saw a menu in the kitchen with only one "choice" on it” from the report
Broken furniture
minorSome bedroom furniture and furniture in an upstairs corridor was broken. Inspectors said this could create an infection control risk.
“Some bedroom furniture was broken in rooms and also we saw broken furniture in an upstairs corridor.” from the report
- 01What has been done to make sure accidents, incidents, behaviour records and risk assessments are completed on one system and reviewed promptly?
- 02What is the current fluid target for the person previously at risk of dehydration, and how is the home checking that staff meet it?
- 03How have medicine records been reorganised, and are handwritten medicine administration records now checked and double signed?
- 04How does the home make sure people are offered meaningful choices at mealtimes and in their daily activities?
- 05Has all broken bedroom and corridor furniture been replaced, and how is the home checking for infection control risks?
This was an unannounced focused inspection of Safe and Well-led; the other key-question ratings were not inspected during this visit and the overall rating used previous ratings for questions not inspected. This explanation was written from the published report of 9 June 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2020
Rated Good overall; inspectors found kind, person-centred care, but the home required improvement in leadership and record keeping.
This was an unannounced inspection on 28 January 2020. Inspectors observed people, spoke with relatives and staff, and reviewed care, medicine, recruitment and management records.
People were described as safe and well supported by staff who knew them well. Inspectors found enough staff, suitable training, good healthcare links, personalised care and activities based on people's interests.
There were some weaknesses in records. Risk records did not always explain how risks were managed, some accident details were missing, and some medicine records lacked important information. Fire drills had not taken place regularly.
The home was rated Good overall and remained Good in Safe, Effective, Caring and Responsive. Well-led remained Requires Improvement, meaning management and oversight were not consistently strong.
Kind and respectful staff
Staff knew people well and understood their preferences, needs and signs of distress. Relatives were happy with the support provided.
“Staff were observed to be kind, patient, respectful and considerate.” from the report
Personalised support
Care plans gave staff detailed information about how to support people. Activities and daily routines reflected individual interests and choices.
“People were supported to spend their days as they wanted.” from the report
Support for independence
People were encouraged to take part in everyday tasks and develop skills through the provider's Active Support approach.
“People were encouraged to remain as independent as possible.” from the report
Staff training and support
Staff received induction, ongoing training, supervision and appraisals. Inspectors found staff knowledgeable about their roles.
“Staff received regular support through supervisions and a yearly appraisal.” from the report
Incomplete risk records
needs fixingRisk assessments did not always record all the actions staff took to reduce risks. This could make it harder to confirm that agreed safety measures were being followed.
“However, records did not include all the details of what staff were doing to mitigate risks.” from the report
Accident records lacked detail
seriousAn incident involving a person's head being bumped on a hoist had not been fully recorded or investigated when inspectors found it. Management began investigating during the inspection.
“No further details were recorded and no investigation done.” from the report
Weak management records
needs fixingThe home had quality checks, but some records were missing dates or needed more detail. The service also had no registered manager while recruitment was ongoing.
“Records needed more attention to detail such as dates were missing.” from the report
Fire drill arrangements
needs fixingFire drills had not been carried out regularly. The last night-time practice was in January 2019, although the regional manager said this would be addressed.
“Fire drill had not taken place regularly. The last night time practice was in January 2019.” from the report
- 01Who is now the registered manager, and how is the home being overseen while recruitment is completed?
- 02How are risk assessments now checked to ensure they explain exactly how staff will reduce each person's risks?
- 03What changes have been made to recording and investigating accidents, including incidents involving equipment such as hoists?
- 04When was the most recent night-time fire drill, and how often are fire drills now carried out?
- 05How are medicine records checked when medicines are stopped or changed?
This inspection looked at the whole service and rated all five CQC questions; the previous inspection in 2017 had also rated the overall service Good. This explanation was written from the published report of 14 February 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Woodham Grange
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2020Goodstayed GoodSafe: GoodWell-led: Requires improvement
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015Goodstayed GoodEffective: Good
- June 2015GoodSafe: GoodEffective: Requires improvementCaring: OutstandingResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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